Association of blood lipids and albumin-bilirubin index with disease progression in patients with chronic hepatitis B virus infection
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摘要: 目的探讨血脂相关指标及白蛋白-胆红素指数(ALBI指数)对慢性HBV感染后疾病进展的评估价值。方法选取2016年6月-2017年6月在安徽医科大学第二附属医院就诊的184例慢性HBV感染者,将其根据不同的疾病阶段分为HBV携带者74例(ASC组),慢性乙型肝炎患者70例(CHB组),代偿期肝硬化患者40例(LC组),并以50例健康对照者作为对照(HC组)。检测血脂相关指标和肝功能指标,分析血脂指标与ALBI指数在慢性HBV感染后疾病进展中的变化特点。计量资料多组间比较采用单因素方差分析,进一步两两比较采用Dunnett法;计数资料组间比较采用χ2检验;相关性分析采用Pearson相关分析法。结果 ASC组、CHB组、LC组、HC组间血脂指标CHO、HDL-C、LDL-C、APOA、APOB差异均有统计学意义(F值分别为12. 075、19. 559、6. 554、9. 392、5. 458,P值均<0. 001);与其他3组比较,LC组以上指标降低最为显著,组间差异均有统计学意义(P值均<0. 05)。ALBI指数在4组间差异有统计学意义(F=49. 225,P <0...Abstract: Objective To investigate the value of blood lipid indices and albumin-bilirubin index ( ALBI) in evaluating the progression ofchronic hepatitis B virus ( HBV) infection. Methods A total of 184 patients with chronic HBV infection who visited The Second AffiliatedHospital of Anhui Medical University from June 2016 to June 2017 were enrolled, and according to the stage of the disease, they were divid-ed into ASC group ( 74 HBV carriers) , CHB group ( 70 patients with chronic hepatitis B) , and LC group ( 40 patients with compensated cir-rhosis) . A total of 50 healthy individuals were enrolled as health control ( HC) group. Blood lipid indices and liver function parameters weremeasured, and the changes in blood lipid indices and ALBI during the progression of chronic HBV infection were analyzed. A one-way a-nalysis of variance was used for comparison of continuous data between multiple groups, and the Dunnett method was used for further compar-ison between two groups; the chi-square test was used for comparison of categorical data between groups; Pearson correlation analysis wasused to investigate correlation. Results There were significant differences between the ASC, CHB, LC, and HC groups in blood lipid indi-ces of cholesterol ( CHO) , high-density lipoprotein cholesterol ( HDL-C) , low-density lipoprotein cholesterol ( LDL-C) , apolipopro-tein A ( APOA) , and apolipoprotein B ( F = 12. 075, 19. 559, 6. 554, 9. 392, and 5. 458, all P < 0. 001) , and the LC group had signifi-cantly greater reductions in the above indices compared with the other three groups ( all P < 0. 05) . There was a significant difference in AL-BI between the four groups ( F = 49. 225, P < 0. 001) ; the LC group had a significantly higher ALBI than the other three groups ( all P <0. 05) , and the ASC and CHB groups had a significantly higher ALBI than the HC group ( both P < 0. 05) . CHO, HDL-C, LDL-C, andAPOA were negatively correlated with ALBI ( all P < 0. 05) , among which CHO and HDL-C had the strongest correlation with ALBI ( r =-0. 310 and-0. 266, both P < 0. 001) . Conclusion In patients with chronic HBV infection, blood lipid indices and ALBI can reflectthe degree of liver function damage, especially in patients with liver cirrhosis.
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Key words:
- hepatitis B virus /
- dyslipidemias /
- apolipoproteins /
- albumin-bilirubin index /
- hepatic insufficiency
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[1] YANG S, LIN Q, LIN W, et al. Effect of adjuvant interferontherapy on hepatitis B virus-related hepatocellular carcino-ma:A systematic review[J]. World J Surg Oncol, 2016, 14 (1) :159. [2] SHI J, SHEN Z, MIAO H, et al. Association between serumlipid levels and antiviral treatment outcome inpatients with chro-nic hepatitis[J]. J Clin Hepatol, 2014, 30 (6) :496-500. (inChinese) 时佳, 沈震, 苗慧, 等.血脂水平与慢性丙型肝炎患者抗病毒疗效的相关性分析[J].临床肝胆病杂志, 2014, 30 (6) :496-500. [3] ABBASI A, BHUTTO AR, BUTT N, et al. Serum cholesterol:Could it be a sixth parameter of Child-Pugh scoring system incirrhotics due to viral hepatitis?[J]. J Coll Physicians SurgPak, 2012, 22 (8) :484-487. [4] WANG CC, TSENG TC, KAO JH. Hepatitis B virus infectionand metabolic syndrome:Fact or fiction?[J]. J Gastroen-terol Hepatol, 2015, 30 (1) :14-20. [5] NAU AL, SOARES JC, SHIOZAWA MB, et al. Clinical and la-boratory characteristics associated with dyslipidemia and liversteatosis in chronic HBV carriers[J]. Rev Soc Bras Med Trop, 2014, 47 (2) :158-164. [6] JOHNSON PJ, BERHANE S, KAGEBAYASHI C, et al. As-sessment of liver function in patients with hepatocellular carci-noma:A new evidence-based approach-the ALBI grade[J]. J Clin Oncol, 2015, 33 (6) :550-558. [7] BO C, SHA L. Albumin-bilirubin (ALBI) score at admissionpredicts possible outcomes in patients with acute-on-chron-ic liver failure[J]. Medicine, 2017, 96 (24) :e7142. [8] Chinese Society of Hepatology and Chinese Society of Infec-tious Diseases, Chinese Medical Association. The guidelinesof prevention and treatment for chronic hepatitis B:A 2015 Up-date[J]. J Clin Hepatol, 2015, 31 (12) :1941-1960. (inChinese) 中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1941-1960. [9] ZHANG C, GONG L, CHEN Y, et al. A human-derived pro-tein SBP (HBsAg-binding protein) can bind to hepatitis B vi-rus surface antigen (HBs Ag) and enhance the immune re-sponse to hepatitis B virus (HBV) vaccine[J]. Mol Immunol, 2013, 53 (1-2) :60-71. [10] VERE CC, NEAGOE D, STREBA CT, et al. Steatosis and ser-um lipid patterns in patients with chronic viral hepatitis:Differ-ences related to viral etiology[J]. Rom J Morphol Embryol, 2010, 51 (3) :509-514. [11] ARAIN SQ, TALPUR FN, CHANNA NA, et al. Serum lipids asan indicator for the alteration of liver function in patients withhepatitis B[J]. Lipids Health Dis, 2018, 17 (1) :36. [12] WU T, ZHENG X, YANG M, et al. Serum lipid alterations iden-tified in chronic hepatitis B, hepatitis B virus-associated cir-rhosis and carcinoma patients[J]. Sci Rep, 2017, 7:42710. [13] GHADIR MR, RIAHIN AA, HAVASPOUR A, et al. The relation-ship between lipid profile and severity of liver damage in cir-rhotic patients[J]. Hepat Mon, 2010, 10 (4) :285-288. [14] BASSANI L, FERNANDES SA, RAIMUNDO FV, et al. Lipidprofile of cirrhotic patients and its association with prognosticscores:A cross-sectional study[J]. Arq Gastroenterol, 2015, 52 (3) :210. [15] CHEN RC, CAI YJ, WU JM, et al. Usefulness of albumin-biliru-bin grade for evaluation of long-term prognosis for hepatitis B-related cirrhosis[J]. J Viral Hepat, 2017, 24 (13) :238-245.
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